Multifaceted intervention to increase the delivery of alcohol brief interventions in primary care: a mixed-methods process analysis

BACKGROUND: Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol- related Harm (REACH) project aimed to increase the delivery of BIs in primary care. AIM: To assess the effectiveness of the REACH programme in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians. DESIGN AND SETTING: This article reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia. METHOD: Time-series analyses were conducted using routinely collected patient records and semi-structured interviews, guided by the consolidated framework for implementation research. RESULTS: The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%). CONCLUSION: REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.